Vaginal myomectomy is a safe and feasible procedure: A retrospective study of 46 cases

Abstract

Vaginal myomectomy is a safe and feasible surgical procedure if performed by a well-trained, experienced surgeon.

Exploring the umbilical and vaginal port during minimal invasive surgery

“…The problem has not yet been completely addressed by surgeons, especially in cases of mass extraction or large specimens. Rolli et al ( 31 ) investigated the feasibility and safety of vaginal myomectomy via posterior colpotomy in a series of 46 consecutive procedures. Thirty-two patients underwent successful vaginal myomectomy under general anesthesia and 12 under loco-regional anesthesia, and the median size of the myomas was 50 mm (range, 16-81 mm).…”

“…Thirty-two patients underwent successful vaginal myomectomy under general anesthesia and 12 under loco-regional anesthesia, and the median size of the myomas was 50 mm (range, 16-81 mm). The authors showed the feasibility of the technique, but they did not address sexual function after surgery, or whether any patients achieved pregnancy after myomectomy ( 31 ).…”

Myoma pseudocapsule - a biological and surgical structure to respect during myomectomy

“…Returning to the fibroid enucleation technique, the possibility to perform myomectomy by removing the myoma from its pseudocapsule was called "intracapsular myomectomy" [16,18,19]. In this technique, the fibroid is taken out, by surgeon, from its muscular fovea, by stretching and enucleating the myoma directly from the adjacent myometrium, avoiding the damage to the adjacent fibromuscular skeleton, breaking up the fibrous bridges ( Figure 3) [4,6,25,26]. As a general surgical recommendation, in robotic, laparoscopic, laparotomic, vaginal, or hysteroscopic setting, the surgical enucleation of each fibroid always needs to be gently performed in order to enhance and improve the successive myometrial healing, trying to correctly restore the uterine anatomy and biology [27,28].…”

“…1 Болница "Верис дели понти", Одељење за акушерство и гинекологију, Скорано, Италија; 2 Болница "Вито Фаци", Одељење за гинекологију и акушерство, Одсек за експерименталну ендоскопску хирургију, имиџинг технологију и минимално инвазивну терапију, Лече, Италија; 3 Moсковски институт за физику и технологију (Државни универзитет), Одсек за примењену математику, интернационални пренос медицинских сазнања и истраживање биолошких модела, Москва, Русија; 4 Клинички центар Србије, Клиника за гинекологију и акушерство, Београд, Србија; 5 Универзитет у Београду, Медицински факултет, Београд, Србија…”

“…Moreover, women affected by fibroids are at a higher risk for complications during pregnancy, labor, and delivery [3]. Fibroids are preferentially treated by surgery, by vaginal, laparoscopic, laparotomic, or hysteroscopic approach [4,5,6].…”